Results: Students performed well in the factual knowledge test but worse in the reasoning tasks. No correlation between factual knowledge and reasoning ability was observed whereas performance in key feature cases was significantly correlated with performance in problem solving tasks. Results in clinical reasoning were positively influenced by cognitive capacity, motivation, clinical experience and the intended career as clinician.

Conclusion: Learning with flashcards is a suitable way to acquire factual knowledge, but does not promote reasoning abilities. In contrast factors like motivation or clinical experience support clinical reasoning.